And Then There Were 20

Two great shifts in a row seem like an amazing gift from above, and as I drove to work I half thought to myself, half prayed for antepartums.  Low and behold that is exactly what I got three high risk antepartums…mag, twins, high blood pressure…the whole bit.  These patients are pretty fun for the most part, as they are often board and chatty and you really get to know them well, even having them only one shift.  Then, if you by chance get them back another time (they can be there for weeks) it is that much more fun.  Keeping up with charting all day, and not having to play catch up was an added bonus, and taking a lunch break plus an additional 15 min. break later on in the shift was the icing on the cake.  Really. I feel rehabbed, like I can do another twenty.  Thank you Lord for caring for me, loving me, and for not giving me more than I can handle, but enough that I am being pushed to grow.
I had time to make a list of the things I have experienced and learned here.
1. How to set up the epidural pump myself.
2. Caring for high risk antepartum moms, with all kinds if diagnoses, down to 18 weeks gestation.
3. Betamethasone- steroids for fetal lung maturity.
4. Transcutaneous Bilirubin (TCB) so much nicer than poking every baby, now if we could only do the metabolic screen with out a poke.
5. Amnisure- a swab test for the presence of amniotic fluid in the vaginal vault.
6. Epic is a frequently used program for computer charting in healthcare systems.  A lot of job postings require epic experience, and now I have it!
7. Post-op GYN patients…ok, I have had some experience with this in my med/surge/Ortho days but that was 10 years ago now, and minimal at best (only when I floated to the surgical floor from my Ortho home unit).
8. Being shared between two hospitals, it’s nice to feel wanted.
9. My first tiny patient with a testicular torsion.
10. My first tiny pt with the urethral opening going from the top of the glands all the way down the front to where the foreskin is attached. AMC joked that they were only going to give me baby girls from here on out. In this process I learned why you don’t circumcise the penis when there is an irregularity…they use the foreskin to make the needed repairs.
11. I learned first hand why rhogam and the antibody screen are so important when my very yellow 20 hour old baby had a bilirubin of 24.6 which I believe ended up needing a transfusion….I was so thankful for the NICU that day.
12. Patient on Methadone that only had half the doses she would need to get her through her hospital stay and the hospital protocols on that (being the go-between between the physician, pharmacy, and the methadone clinic.

I have twenty more shifts, let’s see what else I can learn.

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